February 2023News

New linear accelerator goes into service in Radiation Oncology

Cancer-fighting tool noteworthy for accuracy and versatility

Cancer patients have begun receiving radiation treatment from an ultra-sophisticated and versatile linear accelerator, which has been newly installed at the JGH in the Division of Radiation Oncology.

“It has the capacity to deliver any type of treatment, from the standard to the more complex,” says Dr. Khalil Sultanem, Chief of Radiation Oncology. “In targeting tumours, it delivers carefully calculated doses of therapeutic radiation with much greater accuracy, speed and ease.”

The linear accelerator emits exact amounts of radiation for specific lengths of time. As the patient lies on a special table, the head of the machine (from which the radiation is released) rotates around the patient and can target the tumour from any angle.

Especially noteworthy in the new TrueBeam model, Dr. Sultanem says, is a feature known as “surface-guided technology.” Just before each treatment, the patient’s body is digitally mapped to ensure that he or she is lying in exactly the same position as during the previous visit. This makes it possible for the radiation to be aimed with greater precision at the tumour, in order to minimize exposing healthy tissue to the radiation.

In addition, the linear accelerator has CT scanning capabilities that allow an image of the patient to be captured at each treatment. This helps medical professionals more accurately determine what kinds of changes, if any, are occurring in the tumour from one visit to the next.

“At some point, more than half of cancer patients require radiation therapy,” says Dr. Gerald Batist, Director of the Segal Cancer Centre at the JGH. “This major upgrade will improve the quality and efficiency of those treatments, to the benefit of our patients.”

Renovations supported by Leo and Shirley Goldfarb Foundation

Funding for the renovations to accommodate the new linear accelerator was generously provided by the Leo and Shirley Goldfarb Foundation, in coordination with the JGH Foundation.

According to Dr. Gerald Batist, Director of the Segal Cancer Centre, the late Mr. Goldfarb (a Past President of the JGH) and his wife, Shirley, had a long-standing interest in supporting the Division of Radiation Oncology.

Although the government is paying for the new accelerator, financial assistance was needed for its installation. This prompted Dr. Batist to turn to Mrs. Goldfarb, who agreed to underwrite the cost of the renovations.

Donations can be made online to support the Division of Radiation Oncology or any other aspect of the JGH.

Until now, the Division of Radiation Oncology has had three linear accelerators. The new machine has replaced the oldest one, for a grand total of four—three that are active, with one for back‑up. In addition, plans call for one of the other two active machines to be replaced by the end of this year.

To accommodate the new linear accelerator, construction crews had to transform an empty underground space, known as a shell, into a fortified bunker. When the Division was extensively renovated in 2009, two such shells were included to allow for future expansion.

The concrete walls and ceiling of the new bunker, like those where the other machines are housed, are 2½ to three metres (eight to ten feet) thick to ensure that the only person exposed to the radiation is the patient who is being treated.

Project Manager Richard Boro says the key to the success of the current endeavour was a much greater degree of precision than is required for most other renovation or construction projects in the hospital.

Richard Boro, Project Manager in Technical Services, with the new linear accelerator shortly before it went into service.

Richard Boro, Project Manager in Technical Services, with the new linear accelerator shortly before it went into service. (Click on the photo to enlarge it.)

However, he adds, the real challenge was in coordinating the numerous steps in the construction process, while ensuring that the bunker would be completed on time. Respecting the deadline was essential, because the linear accelerator had to be delivered on a firm date that had been arranged many months earlier.

That deadline was met, with Varian (the American manufacturer) delivering the components on a weekend last October, followed by installation, programming and fine-tuning until the end of January.

“They trucked it in from the United States in a 53-foot trailer truck jam-packed with crates,” Mr. Boro recalls. “They unpacked everything outside and then wheeled it all into place with their own forklift.”

As impressive as the new machine is, Dr. Sultanem notes that it’s just one component in his Division’s broad arsenal of anti-cancer weapons. Included are a brachytherapy suite (inserts radioactive implants into the tissue to kill the tumour), an orthovoltage machine (delivers low-energy radiation to treat skin cancer) and two CT scanners (produce images of the patient to help plan the treatment).

Also being installed in Radiation Oncology is what’s known as a dual-energy CT scanner. Using x-rays of two intensities, it produces images that show the tumour and the body’s surrounding structures with much greater clarity and definition.

“We’ve been looking forward to upgrading the linear accelerator for a long time,” says Dr. Sultanem. “Along with our other tools and technology, it creates many more possibilities in providing treatment, as well as allowing us to increase our capacity for more patients.”

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